This is Steven Salzberg's blog on genomics, pseudoscience, medical breakthroughs, higher education, and other topics, including skepticism about unscientific medical practices. Here's where I can say what I really think about abuses and distortions of science, wherever I see them.

Bad medicine at M.D. Anderson Cancer Center

M.D. Anderson Cancer Center (at the University of Texas) is one of the top cancer treatment centers in the United States, and probably in the world. This makes it especially disheartening to see that they have a new website, Cancerwise, that endorses pseudoscientific treatments; in other words, it promotes bad medicine. From what I can see, most of the site discusses perfectly reasonable topics, which makes their endorsement of “woo” especially insidious – how is a patient, or even a scientist from another discipline, supposed to distinguish the real science from the quackery?

What caught my notice in particular – although this is not the only example – is the article “The 3 Most Common Questions People Ask About Acupuncture” written by Lorenzo Cohen. As I and many others have pointed out in previous blog posts, and as the scientific literature shows quite clearly now, acupuncture does not work. When compared to placebo in published trials, the benefits of ‘sham’ acupuncture, where the needles don’t even pierce the skin, are the same as those for ‘real’ acupuncture. Likewise, when the needles are inserted in random positions instead of the ‘real’ acupuncture points, the effects are indistinguishable. So it doesn’t matter where you place the needles, and it doesn’t matter if they pierce the skin – in other words, the only effect is the placebo effect: if a patient believes in acupuncture, and he/she thinks he/she is getting treatment, then they report a mild, subjective improvement in certain types of pain.

With that in mind, here is a disturbing bit of pseudoscience from Cohen’s article:

“The effects of acupuncture also tend to be cumulative, so it's important not to expect too much too soon. At M. D. Anderson, we consider 8-10 treatments as one course, and for long-term problems, multiple courses may be necessary. I often tell patients with chronic conditions, ‘It's like fertilizing your garden -- don't expect the flowers to bloom tomorrow. In the long-term, though, you should end up with a better result.’ "

This is complete nonsense - there is no scientific data to support it. But what is a patient supposed to think when he/she reads that M.D. Anderson recommends 8-10 acupuncture treatments for their patients?

Cohen also throws in this canard, a quote from his own “integrative medicine” director: “"Can't hurt, might help, why not!" Here’s why: there are real risks to acupuncture, such as infection, and the scientific evidence says the benefit is zero. So here’s my reply: can’t help, might hurt, why do it?

Then, in the section titled “What should I use acupuncture for?”, Cohen writes:

“...it's always a good idea to recommend acupuncture when the patient is: * Experiencing uncontrolled nausea, vomiting or pain. * Experiencing side effects from treatment or medications. * Has failed conventional treatment for symptom control.”

Always? Always? How about “never”? There isn’t a single well-done clinical trial demonstrating the effectiveness of acupuncture for any of these conditions. (For a summary of some of the evidence showing its ineffectiveness, see this link at Science-Based Medicine.) Other scientists at M.D. Anderson (are they even paying attention?) should step in and do something to make it clear that the institution doesn’t recommend pseudoscientific, unproven therapies for anything.

There are other articles promoting pseudoscientific methods on the Cancerwise site, including this one, which applauds Sen. Tom Harkin for his support of NCCAM (which I’ve written about multiple times) and alternative/integrative medicine. I’m sure we’ll see more such articles there, and it’s very dismaying to see woo-meisters like Lorenzo Cohen make progress in their attempts to drag us back into the past, when medicine was little more than guesswork and superstition.

One of our jobs in academia is to be especially critical of ourselves, so when we see an academic center making mistakes, we call them out on it. So I’m joining other bloggers in doing so – notably Orac, who wrote about this same topic last week. (I highly recommend Orac’s lengthy discussion – he thoroughly dismantles Cohen’s claims, including Cohen’s references to studies that supposedly support those claims.) I don’t know who at M.D. Anderson is responsible for the Cancerwise site, but they have a list of 18 authors on that page, and I hope that at least some of them will be concerned to know that they are endorsing pseudoscience.

Here's an idea for another article at Cancerwise: the title can be identical to one of Cohen's section headings: "What should I use acupuncture for?" And the article can be very short, just one word: nothing.

2 comments:

This is frustrating. I wonder if people like Cohen *know* what game they are playing (in the way that devoted Creationists sometimes go to grad school simply to obtain the ability to confuse and mislead the public with their seemingly valid doctorate but medieval world view), or if critical thinking skills are so undervalued in medical school that he really doesn't understand what evidence is required to show that a treatment is effective.

Take for example, a western medical doctor cannot even relieve the sufferings of a diabetic patient. Prescribing metformin and insulin are the two most common treatments. There is scientific data to prove that metformin and isulin reduces sugar level. Does that cure the patient? Is the patient free from the medication? NO! Does the doctor benefits? Yes by constant patient consultation. Does the pharmaceutical companies benefits? Yes by more income through sales of drugs. Does the patient benefits No! (http://diabetes.emedtv.com/metformin/metformin-dangers.html)

The treatment can be compared to killing flies that linger around a pile of poop and not getting rid of the poop! The flies eventually going to come back again. To me that sounds like pseudoscientific treatments too! LOL!